Individual
MARA CHILDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4777 KY ROUTE 850, HIPPO, KY 41653-8331
(606) 791-7435
Mailing address
4777 KY ROUTE 850, HIPPO, KY 41653-8331
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
BOTOCT00222178
KY
Other
Enumeration date
09/02/2015
Last updated
09/02/2015
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